Top 28378 Pre certification representative Jobs

Accounts Representative - Part-Time
Network Recovery Services, Inc. —Jericho, NY
- $34.30 - $40.55 an hour
- Part-time
- Hybrid work
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
- Paid training
- Work from home
Quick Apply
Case Reviewer (Experienced)
CACI —Remote
- $54,800 - $115,000 a year
- Full-time
- Customer service
- Computer literacy
- Pass drug screening
- Health insurance
Supervisor (Clinical Adjudication) (Part C)
TMF Health Quality Institute —Remote
- Weekends as needed
- Remote
- Nursing
- Writing skills
- Supervising experience
- AD&D insurance
- Disability insurance
Contact Center Associate 1 - UHealth Connect (Remote)
University of Miami —Medley, FL
- Full-time
- Remote
- Spanish
- Computer literacy
- HIPAA
- Health insurance
- Dental insurance
Financial Clearance Representative I - Remote
Roswell Park Cancer Institute —Buffalo, NY
- From $21.81 an hour
- Full-time
- Remote
- High school diploma or GED
- 1 year
- Communication skills
Patient Representative
Hennepin Healthcare —Minneapolis, MN
- $33.17 - $49.75 an hour
- 8 hour shift
- Acute care
- Spanish
- Psychiatry
- Disability insurance
- Health insurance
14d
Supervisor (Clinical Adjudication) Weekday Evening Shift - Flexible Scheduling (Part C)
TMF Health Quality Institute —Remote
- Full-time
- Nursing
- Writing skills
- Supervising experience
- AD&D insurance
- Disability insurance
Credit Counselor - Level 1
Navicore Solutions Inc —Remote
- $20 an hour
- Full-time
- Remote
- Microsoft Outlook
- Computer literacy
- Pass drug screening
- Health insurance
- Dental insurance
Quick Apply
Urgent Admission Specialist, FT, Days- Remote
Prisma Health —Columbia, SC
- Full-time
- Remote
- Customer service
- Word processing
- Computer literacy
Financial Clearance Representative Associate, Retail Pharmacy Prior Authorization
Optum —Minneapolis, MN
- $16 - $29 an hour
- Full-time
- Remote
- 18 years or older
- Customer service
- Pass drug screening
12d
Surgical Representative
Rutgers University —New Brunswick, NJ
- $31.53 an hour
- Full-time
- Surgery
- 5 years
- Mid-level
- Paid holidays
- Dental insurance
Billing Department - Pre-Certification Speci
Suburban Hematology Oncology —Lawrenceville, GA
- $24 - $28 an hour
- Full-time
- Clinic experience
- Mid-level
- High school diploma or GED
Quick Apply
Insurance Authorization Rep
Blue Cloud Pediatric Surgery Centers —Phoenix, AZ
- $18 - $20 an hour
- Overtime
- Remote
- Bachelor of Science
- Medical office experience
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
Training Facilitator
HealthEdge —Remote
- $69,000 - $79,000 a year
- Full-time
- Mid-level
- Bachelor's degree
- Criminal background check
5d
Clinic Pre-Encounter Rep/Prior Authorization: Therapy Representative
McKenzie Health —Watford City, ND
- Weekends as needed
- Background check
- Word processing
- Computer literacy
Quick Apply
Financial Clearance Center Representative
Catholic Health —Melville, NY
- $21 - $27 an hour
- No high school diploma
- High school diploma or GED
- Analysis skills
- Health insurance
- Tuition reimbursement
Pre-Service Representative
Ovation Healthcare —Welcome, SC
- Full-time
- Hybrid work
- HIPAA
- High school diploma or GED
- Typing
Contact Center Representative (up to $21.00 DOE)
MedQuest Associates LLC —Winston-Salem, NC
- $18.50 - $21.00 an hour
- Full-time
- High school diploma or GED
- Typing
- 1 year
Quick Apply
Pre-Services Representative - Remote
Surgery Partners —Nashville, TN
- Remote
- Mid-level
- High school diploma or GED
- Conflict management
- Health savings account
- Health insurance
Quick Apply
2d
Account Assistant 4
Yale University —New Haven, CT
- $31.05 - $31.83 an hour
- Full-time
- Remote
- Background check
- Microsoft Excel
- Management

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Accounts Representative - Part-Time

Network Recovery Services, Inc.
Jericho, NY

Quick Apply

Job Details

Part-time
$34.30 - $40.55 an hour

Benefits

Paid training
Work from home
Opportunities for advancement

Qualifications

Microsoft Word
Microsoft Excel
Microsoft Outlook
Presentation software
Spreadsheets
Patient management software
High school diploma or GED
ICD-9
HCPCS
Insurance medical billing
Electronic health record (EHR) management for billing and coding
Patient billing
Medical billing account reconciliation
Patient interaction
Epic

Full Job Description

Position Summary

Under general supervision, responsible for a variety of office/clerical tasks relating to hospital accounts; contacting patients and responsible parties, investigating account status, and assisting patients with any questions regarding their bill.

Essential Job Duties

· Responsible for obtaining and verifying insurance coverage by interviewing patients, families, and employers and by verifying coverage with insurance companies. Ensure that notifications, authorizations, pre-certifications are made, when appropriate.

· Assist self-pay patients in obtaining coverage for hospitalization, e.g., Medical applications, COBRA regulations. Secure promise of payments for patient for all non-covered services.

· Ensure that all patients are categorized correctly with regard to financial class, insurance company code, etc. Work with medical areas, e.g., Patient Case Management, physician’s offices, to ensure that requested clinical information is supplied timely.

· Receive and process information required submitting a third party bill. Ensure that bills are complete and comprehensive, e.g. correct form for ID numbers, comprehensives of hospital charges, validity of CPT-4, ICD-9, and HCPCS codes. Ensure that billing amounts are correct with regard to case payers, managed care providers with contracts, DRG’s day and cost outliners, implantable, exempt services, carve-outs, type of contract, services under NYPHRM, services under HCRA, etc.

· Obtain and submit all attachments, as required, such as biopsy reports, ambulance call reports, medical records, CMNs, Tao’s.

· For electronic claims: maintain up-to-date knowledge with respect to electronic claim submission software and the various payers edits. Review and monitor all billing exception reports for correction/re-submission. Ensure that all claims are submitted in the accepted timeframe.

· Review and take appropriate action on account representative’s respective portion of trial balance. If a self-pay patient, call patient for further insurance information and /or to secure payment or arrange payment plan.

· Resolve all credit balances by requesting refund to patient, insurance company, or make appropriate allowance transaction. Recommend further action, i.e. collection and/or legal after departmental collection policies have been exhausted.

· Respond to and investigate all patient inquiries involving financial issues; direct patients to appropriate parties to respond to clinical issues.

· Call insurance companies to secure payment. Take appropriate action upon denial or request for further information. Interface with Medical Records Department/physicians office/clinical area for requested information. Make claims corrections in accordance with compliance policies, payer regulations, and/or legal policies. Review exception reports received from remittance processing area and take appropriate action.

· Process all Medicare, Medicaid, and Blue Cross-payments for all participating hospitals through electronic remittance processing software. Post all checks and lockbox remittances manually.

· Prepare daily reconciliation of all remittances and checks posted to ensure that all payments and adjustments are done accurately and agree to deposits posted to general ledger.

· Review each payment for compliance to rules for carrier; post appropriate allowances. Refer all cases that have been paid incorrectly to the insurance follow-up unit. Make appropriate refund requests when overpayments have been identified.

· Ensure that payment posting is kept up-to-date.

· If assigned to Emergency Paramedics department, may assist in the research and preparation of statistical reports.

· If assigned to Emergency Paramedics department, may monitor entries of 911 call data by dispatchers. Reconcile all dispatch entries with documentation. Investigate, correct, and report discrepancies between data input and documentation. Review documentation for compliance with department policy and report any incidents of non-compliance.

· Performs other job related duties as assigned.

Required Criteria

High School Diploma or GED
Exceptional communication skills – verbal and written
Computer and systems competency in the following areas: working knowledge of health systems and interfaces, Microsoft Word, Microsoft Excel, Microsoft Outlook, Microsoft PowerPoint and electronic health records (Epic Preferred)
One year related experience

Benefit Conditions:

Only full-time employees eligible

Paid Training:

Typical end time:

9 PM

Typical start time:

5 PM

Work Remotely

Remote (one day in office or for training as needed)

Job Type: Part-time

Pay: $34.30 - $40.55 per hour

Benefits:

Opportunities for advancement
Paid training
Work from home

People with a criminal record are encouraged to apply

Work Location: Hybrid remote in Jericho, NY 11753

Quick Apply

Refine Your Search

pre certification representative jobs

Accounts Representative - Part-Time

Case Reviewer (Experienced)

Supervisor (Clinical Adjudication) (Part C)

Contact Center Associate 1 - UHealth Connect (Remote)

Financial Clearance Representative I - Remote

Patient Representative

Supervisor (Clinical Adjudication) Weekday Evening Shift - Flexible Scheduling (Part C)

Credit Counselor - Level 1

Urgent Admission Specialist, FT, Days- Remote

Financial Clearance Representative Associate, Retail Pharmacy Prior Authorization

Surgical Representative

Billing Department - Pre-Certification Speci

Insurance Authorization Rep

Training Facilitator

Clinic Pre-Encounter Rep/Prior Authorization: Therapy Representative

Financial Clearance Center Representative

Pre-Service Representative

Contact Center Representative (up to $21.00 DOE)

Pre-Services Representative - Remote

Account Assistant 4

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